Page 24 - Summer2009

THYROID BASICS

The thyroid gland is located at the base of the neck and makes thyroxin (thyroid hormone or T4) which signals the
cells to make energy.
The adrenal glands are located on top of the kidneys, they make many hormones (cortisol, DHEA etc.). Their main
function is to help us deal with stress or help us survive. They help maintain stability of many bodily functions (physical,
emotional, thermal, hormonal etc.). When there is stress—anything physical, chemical, emotional, nutritional or lifestyle
such as sleep patterns, which causes us to have to adapt—the adrenals need to work. Excessive stress can exhaust them.
One often overlooked adrenal stressor is thyroid energy in excess of what the adrenals can handle.
The pituitary gland is situated at the base of the brain (above the roof of the mouth). It sends out instructions to many
glands, including the thyroid gland, telling them how much hormone to produce. One such hormone is TSH (Thyroid
Stimulating Hormone) which signals to the thyroid gland to make thyroid hormone. The pituitary gland determines how
much TSH to secrete (that is, how much thyroid hormone to tell the thyroid gland to make) based on (1) how much
thyroid hormone is available; (2) how much thyroid hormone the body needs; and (3) how much thyroid hormone the
body (actually the adrenals) can tolerate.
Thus a high TSH level is the pituitary gland’s way of saying that it has a high need for thyroid hormone or that the
body can tolerate more thyroid energy than it is getting, and it is meant to generate more thyroid hormone produc-
tion. Conversely, a low TSH reflects either a low need or desire for thyroid hormone or a low tolerance for the thyroid
hormone, and it is meant to reduce thyroid hormone production. An optimal value of TSH means the thyroid hormone
levels match the body’s energy needs and/or ability to utilize the energy.
The thyroid gland makes a hormone called T4 (thyroxine). T4 will become T3 (triiodothyronine) which causes en-
ergy (in the form of ATP) to be made in each living cell. T4 can also become reverse T3 (RT3) which interferes with the
energy production in the cell. Just as a car needs an accelerator and brakes for proper function, the same is true for the
body. The body needs T3 (the accelerator) and RT3 (the brake) to manage its energy needs.
To summarize, T4 has four iodine atoms and it is a pro-hormone, that is, it lives to become either T3 or RT3. When
the body needs energy, it removes an iodine atom from the T4 and turns it into T3, which in turn signals living cells to
make energy (ATP). T3 allows the body to turn up the energy when it needs to. Reverse T3 (RT3) is made by the body to
tone down energy. It is made by removing a different iodine from T4. Like placing a bad key in the ignition, it blocks the
T3 (the working key) from signaling the cell to make energy. It allows the body to turn down the energy when it needs
to. Rather than looking at the values as low-normal-high, we can make more sense of the data if we look at each value
as it relates to the optimal value. In my practice, I have found the following to correspond to the healthiest segment of
the population and which I do not fine to be associated with symptoms of thyroid excess or deficiency. First, a word
on thyroid tests.
Thyroid hormones (T4, T3, and RT3), once released into the bloodstream, exist either as protein-bound or in a
free form. Protein acts as a sponge or reservoir to which hormones bind and then can be freed. Hormone in free form
is available to interact with a cell’s receptor site to produce its hormonal effect. It is only the free form hormone that is
biologically available or active. When the hormone is bound to a protein it is restrained from interacting with a cell’s
receptor site.
I typically test for the following: free T3, free T4 and TSH. If there is a suspicion of Hashimoto’s thyroiditis, I include
a thyroid peroxidase antibody test (TPO) and an antithyroid antibody test (ATA). I also use this to monitor the severity
of the Hashimoto’s thyroiditis and to see whether therapy is working. If there is suspicion of Graves’ disease, I include
TSI. Based on my observation of nearly 5,000 patients and the lab test values that my healthiest patients tended to
have, I believe the optimal values for these tests, within a 5-10 percent margin of error, are as follows:

TEST LAB LOW OPTIMAL RANGE LAB HIGH
TSH 0.5 1.3-1.8 5.0
Free T4 0.8 1.2-1.3 1.8
Free T3* 230 (2.3) 320-330 (3.2-3.3) 420 (4.2)

*Some labs divide FT3 results by 100 thus 230 is the same as 2.3, etc.

In the cases of Free T4 (FT4) and Free T3 (FT3), the optimal zone is roughly half way between the usual lab normal
low-high values. In the case of TSH, the optimal zone is skewed far toward the low end of the standard lab Low-High
range. For further details, visit www.drrind.com/therapies/thyroid-scale.

22 Wise Traditions SUMMER 2009